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Frequently Asked Questions about RE-AIM:
The Basics (FAQs page 1)
RE-AIM is an acronym that consists of five elements, or dimensions, that relate health behavior interventions: • Reach
the target population How do you define each element? Reach — The absolute number, proportion,
and representativeness of individuals who participate in a given program. Efficacy/Effectiveness — The impact of an intervention on important outcomes. This includes potential negative effects, quality of life, and costs. Adoption — The absolute number, proportion, and representativeness of settings and staff who are willing to offer a program. Implementation — At the setting level, implementation refers to how closely staff members follow the program that the developers provide. This includes consistency of delivery as intended and the time and cost of the program. Maintenance — The extent to which a
program or policy becomes part of the routine organizational practices and
policies. Within the RE-AIM framework, maintenance also applies at the individual
level. How do elements relate to planning? As you design, plan, or evaluate a health behavior intervention, there are questions that you should ask yourself.
• Reach the target population • Efficacy or effectiveness • Adoption by target settings or institutions • Implementation - consistency of delivery of intervention • Maintenance of intervention effects in individuals and populations over time Which RE-AIM element is the most important? (Isn't Reach really the bottom line in what you are trying to get at?) Some have argued that Reach is the most important criteria, but we think that all five RE-AIM dimensions are equally important. An intervention with high Reach, but little or no Efficacy will have limited impact. Similarly, even if an intervention has high reach and impressive Efficacy, if no organizations will Adopt the intervention, or if only a handful of experts can successfully Implement the program, it will have limited real world impact. Why isn't cost one of the RE-AIM dimensions—it is so important to adoption and other issues? We agree that cost is often one of the key factors in determining how widely Adopted an intervention will be. However, we view cost, or cost-effectiveness and cost-benefit, as one of the factors that influences several RE-AIM dimensions in addition to adoption; for example, cost is usually related to intensiveness of intervention which is often related (positively) to Efficacy and (negatively) to Implementation. How is RE-AIM different from other evaluation approaches? RE-AIM draws upon previous work in several areas including diffusion of innovations, multi-level models, and Precede-Proceed. The primary ways that it is different is that it a) is intended specifically to facilitate translation of research to practice, b) it places equal emphasis on internal and external validity issues and emphasizes representativeness, and c) it provides specific and standard ways of measuring key factors involved in evaluating potential for public health impact and widespread application. How is the RE-AIM definition of Implementation different from concepts such as intervention delivery, receipt of intervention, or implementation fidelity? In the RE-AIM framework, Implementation is closely related to the above issues. However, it has a greater focus on the intervention setting level and on the staff delivering the program and what they do, rather than on what the individual participant who receives a program does. Both are important, but RE-AIM places emphasis on the potential implications for delivering intervention in applied settings, and on assessing Implementation for different components of the program and across diverse intervention staff. Is RE-AIM used to design programs, or just to evaluate them? It is both. Although used more commonly at present to report results or compare interventions, it is also intended as a planning tool. These articles provide examples of reporting results: These articles provide examples of using RE-AIM to evaluate evidence and review the literature: |
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Place
your mouse on any element below (reach, efficacy, etc.) to display a planning
question related to it.